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SOUTH COAST MECHANICAL
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Last modified
8/19/2024 9:37:28 AM
Creation date
3/26/2021 11:27:03 AM
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Contracts
Company Name
SOUTH COAST MECHANICAL
Contract #
A-2021-036-05
Agency
Public Works
Council Approval Date
3/16/2021
Expiration Date
3/31/2024
Insurance Exp Date
4/1/2024
Destruction Year
2029
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Attachment Code: D590796 Certificate ID: 18621354 <br />WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 <br />(Ed. 4-84) <br />WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT <br />We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce <br />our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you <br />perform work under a written contract that requires you to obtain this agreement from us.) <br />This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. <br />Schedule <br />Where required by written agreement signed prior to loss. <br />This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. <br />(The information below is required only when this endorsement is issued subsequent to preparation of the <br />policy.) <br />Endorsement Effective Policy No. Endorsement No. <br />Insured RWD3001476-03 Premium Included <br />SOUTH COAST MECHANICAL, LLC <br />Insurance Company Countersigned by <br />XL Insurance America, Inc. <br />WC000313 <br />(Ed. 4-84) <br />1 1983 National Council on Compensation Insurance. <br />Risk Muagment DlMsian <br />ZREVIEWED & APPROVED BY: <br />e eev Risk Management Specialist <br />
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